Lisinopril is a medicine to treat high blood pressure (hypertension) and heart failure.
It's also prescribed after a heart attack and helps prevent future strokes and heart attacks. It also improves your survival if you're taking it after a recent heart attack or for heart failure.
It works by widening your blood vessels and making it easier for your heart to pump blood around your body.
It can also be used for diabetic kidney disease, to slow down the disease.
Lisinopril is only available on prescription. It comes as tablets.
It also comes as a liquid for people who find it hard to swallow tablets.
Lisinopril is also available combined with another blood pressure medicine called hydrochlorothiazide. This is called by the brand names Zestoretic or Lisoretic.
Who can take lisinopril
Most adults and children aged 6 years and over can take lisinopril.
If you have diabetes, check your blood sugar (glucose) more often, particularly in the first few weeks. This is because lisinopril can lower the sugar level in your blood.
Who may not be able to take lisinopril
Lisinopril is not suitable for some people. To make sure it's safe for you, tell your doctor if you:
- have ever had an allergic reaction to lisinopril or any other medicine
- are trying to get pregnant, are already pregnant or breastfeeding
- are having dialysis or any other type of blood filtration
- have heart, liver or kidney problems
- have unstable or low blood pressure
- have diabetes
- are going to have a major operation (surgery) or general anaesthetic to put you to sleep
- have recently had diarrhoea or vomiting
- are on a low-salt diet
- are going to have desensitisation treatment to reduce your allergy to insect stings
- have a blood problem, such as a low white blood cell count (neutropenia or agranulocytosis)
The dose of lisinopril you take depends on why you need the medicine. Take it how your doctor tells you to.
To decide your dose, your doctor will check your blood pressure and ask you if you're getting any side effects from your medicine.
You may also have blood tests to check how well your kidneys are working and the amount of potassium in your blood.
Depending on why you're taking lisinopril, the usual starting dose for adults is between 2.5mg and 10mg, once a day.
This will be increased gradually over a few weeks to the usual dose for your condition:
- high blood pressure – 20mg once a day (the maximum dose is 80mg once a day)
- after a recent heart attack – 10mg once a day
- heart failure – 5mg to 35mg once a day
- diabetic kidney disease – 10mg to 20mg once a day
Doses are usually lower for children. The doctor will work out the right dose based on your child's age, weight and why they need this medicine.
Your child will usually start on a low dose of lisinopril. This dose may gradually increase depending on your child's blood pressure and other symptoms.
How to take it
You'll usually take lisinopril once a day.
Your doctor may suggest that you take your first dose before bedtime because it can make you dizzy.
After the very first dose, you can take lisinopril at any time of day. Try to take it at the same time every day.
You can take lisinopril with or without food. Swallow lisinopril tablets whole with a drink of water.
If you're taking lisinopril as a liquid, it will come with a plastic syringe or spoon to help you measure out the right dose. If you do not have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount of medicine.
Changes to your dose
You'll probably be prescribed a low dose of lisinopril at first so it does not make you feel dizzy.
This will usually be increased gradually until you reach the right dose for you.
Speak to your pharmacist or doctor about your dose if you're worried about side effects of lisinopril.
How long to take it for
After a heart attack, you usually take lisinopril for 6 weeks. Your doctor will then decide if you need to keep taking it for longer.
For high blood pressure, heart failure and diabetic kidney disease, treatment with lisinopril is usually long term, even for the rest of your life.
Take lisinopril even if you feel well, as you'll still be getting the benefits of the medicine.
Contact your doctor if you get ill, such as a high temperature, sweats and shaking or severe diarrhoea or vomiting. Your doctor may advise you to stop taking lisinopril until you recover and are eating and drinking normally.
If you forget to take it
If you miss a dose of lisinopril, take it as soon as you remember. If you do not remember until the following day, skip the missed dose and take your next dose at the usual time.
Do not take a double dose to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
If you take too much
Taking more than your prescribed dose of lisinopril can make you feel dizzy, sleepy and give you a pounding heartbeat (heart palpitations).
The amount of lisinopril that can lead to an overdose varies from person to person.
- you take more than your prescribed dose of lisinopril
Go to 111.nhs.uk or call 111
If you need to go to A&E, do not drive yourself. Get someone else to drive you or call for an ambulance.
Take the lisinopril packet or leaflet inside it, plus any remaining medicine, with you.
Common side effects
These common side effects of lisinopril happen in more than 1 in 100 people. Talk to your doctor or pharmacist if these side effects bother you or do not go away:
It happens rarely, but some people may have serious side effects when taking lisinopril.
Call a doctor or contact 111 straight away if:
- the whites of your eyes turn yellow, or your skin turns yellow although this may be less obvious on brown or black skin – this can be a sign of liver problems
- you're paler than usual, feel tired, faint or dizzy, have any sign of bleeding (for example bleeding from the gums or bruising more easily than usual), a sore throat, a fever, or you get infections more easily – these can be signs of a blood or bone marrow disorder
- you have severe stomach pain – this can be a sign of an inflamed pancreas (acute pancreatitis)
- you have swollen ankles or blood in your pee or you're not peeing at all – these can be signs of kidney problems
Go to 111.nhs.uk or call 111.
- you have weakness on one side of your body, trouble speaking or thinking, loss of balance or blurred eyesight – these can be signs of a stroke
- you have a faster heart rate, chest pain and tightness in your chest – these can be signs of heart problems
- you have shortness of breath, wheezing and tightening of the chest – these can be signs of lung problems
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to lisinopril.
Taking lisinopril for a long time can sometimes cause your kidneys to not work as well as they should. Your doctor will check how well your kidneys are working with regular blood tests.
Other side effects
These are not all the side effects of lisinopril. For a full list, see the leaflet inside your medicines packet.
Lisinopril and pregnancy
Lisinopril is not recommended in pregnancy. It can affect your baby's kidneys, particularly if it's taken in the second and third trimesters of pregnancy. This can result in long term damage to your baby's kidneys and poor development of your baby's lungs.
If you're already pregnant, stop taking lisinopril and talk to your doctor as soon as possible. Usually your doctor will be able to prescribe a different medicine that is safe to take in pregnancy. Lisinopril should be stopped by the time you're 12 weeks pregnant at the latest.
Use contraception if you're taking lisinopril and carefully plan any pregnancy with your doctor, obstetrician or hospital doctor. They will want to review your medical condition and medicine before you get pregnant.
Most women come off lisinopril before getting pregnant, but some may continue up until they have a positive pregnancy test and then stop. Your doctor will discuss what's best for you, based on your medical condition and the risks and benefits of lisinopril.
Lisinopril and breastfeeding
It might be OK to take lisinopril while breastfeeding, but talk to your doctor or pharmacist first. It's best not to take lisinopril if your baby was born prematurely, but your doctor will help you decide.
It's not yet known how much lisinopril passes into breast milk, but it's likely to be a small amount. It is unlikely to cause side effects in your baby. However, there is a very small risk that it could also lower your baby's blood pressure. Your doctor might recommend a different medicine for you to take while breastfeeding.
If you notice that your baby is not feeding as well as usual, seems unusually sleepy, seems much paler than usual, or if you have any other concerns about your baby, talk to your health visitor, midwife or doctor as soon as possible.
Lisinopril and fertility
There's no clear evidence to suggest that taking lisinopril reduces fertility in either men or women.
Speak to a pharmacist or your doctor if you're trying to get pregnant. They will want to review your treatment with you.
Cautions with other medicines
There are some medicines that may affect the way lisinopril works.
Tell your doctor if you're taking any of these medicines:
- anti-inflammatory medicines, such as ibuprofen, indomethacin or aspirin for pain relief (low-dose aspirin – 75mg a day, is safe to take with lisinopril)
- medicines to treat low blood pressure, heart failure, asthma or allergies, such as ephedrine, noradrenaline or adrenaline
- medicines to treat high blood pressure, such as aliskeren
- other medicines that can lower your blood pressure, such as some antidepressants, nitrates (for chest pain), baclofen (a muscle relaxant), anaesthetics, or medicines for an enlarged prostate gland
- medicines that calm down your immune system, such as ciclosporin or tacrolimus
- medicines that make you pee more (diuretics), such as furosemide
- medicines that can increase the amount of potassium in your blood, such as spironolactone, triamterene, amiloride, potassium supplements, trimethoprim (for infections) or heparin (for preventing blood clots)
- steroid medicines such as prednisolone
- allopurinol (for gout)
- procainamide (for heart rhythm problems)
- medicines for diabetes
- racecadotril (for diarrhoea)
- lithium (for mental health problems)
Mixing lisinopril with herbal remedies or supplements
There's very little information about taking herbal remedies and supplements with lisinopril. They're not tested in the same way as pharmacy and prescription medicines.
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